European Declaration of health professionals Towards non-discriminatory access to health care

Undocumented migrants face many problems getting access to health care in most European Union member states. These problems are due to laws which restrict or eliminate health coverage. There are additional problems which result from complex health systems, and the fact that some migrants fear being arrested, are refused access to healthcare, or discriminated against.

This goes against our professional code of ethics which reminds us that “every person is entitled without discrimination to appropriate medical care… (and) physicians and other persons or bodies involved in the provision of health care have a joint responsibility to recognize and uphold these rights. Whenever legislation, government action or any other administration or institution denies patients these rights, physicians should pursue appropriate means to assure or to restore them” 1. The GMC Good Medical Practice code of ethics further reminds us that “all patients are entitled to care and treatment to meet their clinical needs.”2

We must never allow discrimination to adversely affect the treatment we provide. We alone are responsible for upholding our ethical obligations, and will not be dissuaded from doing so.

In view of this situation we:

1. Reassert our loyalty to the professional codes of ethics which ask us to care for all patients without discrimination. We ask to be allowed to perform our professional responsibilities with the utmost respect to our code of ethics.

2. Request that we be able to determine in a given situation what healthcare should be provided to a patient, based upon clinical judgment alone and without regard to status.

3. Request that decisions about the provision of healthcare remain with clinical staff and not administrative staff.

4. Request that in cases where the individual is unable to pay, the provision of healthcare to undocumented migrants be paid for by public funds, in line with the NHS Constitution and its core objectives.

5. Reiterate that healthcare professionals are free to provide services to undocumented migrants. We are bound to respect the confidentiality of all patients and will not share their confidential details, even where their status is in question by governmental authorities.

6. Request the removal of organisational impediments which keep health professionals from providing healthcare to undocumented migrants.

7. Denounce the fact that some European countries have criminalised the provision of healthcare to undocumented migrants.

8. Highlight the need for greater awareness of the rights and responsibilities of healthcare professionals to provide care to undocumented migrants, alongside the need for greater awareness of the rights and responsibilities of undocumented migrants relative to accessing healthcare.

1 World Medical Association Declaration on the Rights of the Patient, preamble.

2 General Medical Council Good Medical Practice Code of Ethics (2006), paragraph 11.